Socioeconomic inequality profiles in physical and developmental health from 0-7 years : Australian National Study

Background: Early and persistent exposure to socioeconomic disadvantage impairs children’s health and wellbeing. However, it is unclear at what age health inequalities emerge or whether these relationships vary across ages and outcomes. We address these issues using cross-sectional Australian population data on the physical and developmental health of children at ages 0-1, 2-3, 4-5 and 6-7 years. Methods: 10 physical and developmental health outcomes were assessed in 2004 and 2006 for two cohorts each comprising around 5000 children. Socioeconomic position was measured as a composite of parental education, occupation and household income. Results: Lower socioeconomic position was associated with increased odds for poor outcomes. For physical health outcomes and socio-emotional competence, associations were similar across age groups and were consistent with either threshold effects (for poor general health, special healthcare needs and socio-emotional competence) or gradient effects (for illness with wheeze, sleep problems and injury). For socio-emotional difficulties, communication, vocabulary and emergent literacy, stronger socioeconomic associations were observed. The patterns were linear or accelerated and varied across ages. Conclusions: From very early childhood, social disadvantage was associated with poorer outcomes across most measures of physical and developmental health and showed no evidence of either strengthening or attenuating at older compared to younger ages. Findings confirm the importance of early childhood as a key focus for health promotion and prevention efforts.

Project alliancing Vs project partnering : a case study of the Australian National Museum project

Significant differences between project partnering and project alliancing occur in the selection process, management structure of the organisations undertaking the project and nature of risk and reward incentives. This paper helps clarify the nature of project alliancing and how alliance member organisations were selected for this case study. A core issue that differentiates between the two approaches is that in partnering, partners may reap rewards at the expense of other partners. In alliancing each alliance member places their profit margin and reward structure ÁÁat riskÂÂ. Thus in alliancing, the entire alliance entity either benefits together or not all. This fundamentally changes the motivation and dynamics of the relationship between alliance members.

The future of the internet economy : addressing challenges facing the implementation of the Australian national broadband network

Innovation is vital for the future of Australia.s internet economy. Innovations rely on businesses. ability to innovate. Businesses. ability to innovate relies on their employees. The more these individual end users engage in the internet economy, the better businesses. engagement will be. The less these individual end users engage, the less likely a business is to engage and innovate. This means, for the internet economy to function at its fullest potential, it is essential that individual Australians have the capacity to engage with it and participate in it. The Australian federal government is working to facilitate the internet economy through policies, legislation and practices that implement high-speed broadband. The National Broadband Network will be a vital tool for Australia.s internet economy. Its .chief importance¡® is that it will provide faster internet access speeds that will facilitate access to internet services and content. However, an appropriate infrastructure and internet speed is only part of the picture. As the Organisation for Economic Co-operation and Development identified, appropriate government policies are also needed to ensure that vital services are more accessible by consumers. The thesis identifies essential theories and principles underpinning the internet economy and from which the concept of connectedness is developed. Connectedness is defined as the ability of end users to connect with internet content and services, other individuals and organisations, and government. That is, their ability to operate in the internet economy. The NBN will be vital in ensuring connectedness into the future. What is not currently addressed by existing access regimes is how to facilitate end user access capacity and participation. The thesis concludes by making recommendations to the federal government as to what the governing principles of the Australian internet economy should include in order to enable individual end user access capacity.

Rethinking regulatory design : The Australian National Classification Scheme review

This paper considers issues of methodological innovation in communication, media and cultural studies, that arise out of the extent to which we now live in a media environment characterised by an digital media abundance, the convergence of media platforms, content and services, and the globalisation of media content through ubiquitous computing and high-speed broadband networks. These developments have also entailed a shift in the producer-consumer relationships that characterised the 20th century mass communications paradigm, with the rapid proliferation of user-created content, accelerated innovation, the growing empowerment of media users themselves, and the blurring of distinctions between public and private, as well as age-based distinctions in terms of what media can be accessed by whom and for what purpose. It considers these issues through a case study of the Australian Law Reform Commission's National Classification Scheme Review.

Evaluating the economics of the Australian National Hand Hygiene Initiative

The National Hand Hygiene Initiative, implemented in Australia in 2009, is currently being evaluated for effectiveness and cost-effectiveness by a multidisciplinary team of researchers. Data from a wide range of sources are being harvested to address the research questions. The data are observational and appropriate statistical and economic modelling methods are being used. Decision makers will be provided with new knowledge about how hand hygiene interventions should be organised and what investment decisions are justified. This is novel research and the authors are unaware of any other evaluation of hand hygiene improvement initiatives. This paper describes the evaluation currently underway.

Mixed methods research approach to the development and review of competency standards for dietitians

Aim: Competency standards support a range of professional activities including the accreditation of university courses. Reviewing these standards is essential to ensure universities continue to produce well equipped graduates, who can meet the challenge of changing workforce requirements. This paper has two aims: a) to provide an overview of the methodological approaches utilised for compilation and review of the Competency Standards for Dietetics and b) to evaluate the Dietitians Association of Australia’s Competency Standards and capture emerging and contemporary dietetic practice. Methods: A literature review of the methods used to develop Competency Standards for dietitians in Australia, including entry level, advanced level and DAA Fellow competencies and other specific areas of competency, such as public health nutrition and nutrition education is outlined and compared to other allied health professions. The mixed methods methodology used in the most recent review is described in more detail. Results: The history of Dietetic Competency Standards development and review in Australia is compared to dietetic Competency Standards internationally and within other health professions in Australia. The political context in which these standards have been developed in Australia and which has determined their format is also discussed. The results of the most recent Competency Standards review are reported to highlight emerging practice in Australia. Conclusion: The mixed methods approach used in this review provides rich data about contemporary dietetic practice. Our view supports a planned review of all Competency Standards to ensure practice informs education and credentialling and we recommend the Dietitians Association of Australia consider this in future

Child-related factors that influence teacher-child relationships using an Australian national sample

This study assessed the extent to which child-related factors had an impact on teacher-child relationships in Australian childcare settings. Analyses used data from Growing Up in Australia: The Longitudinal Study of Australian Children (LSAC). The sample consisted of 1577 two to three year old children (M= 33.9 months, SD=2.93; 51.5% male). Two separate hierarchical multiple regression analyses were conducted to examine the relation between teachers’ perceptions of their relationships with children and (a) gender, (b), indigenous status, (c), language background other than English, (d), socio-economic position, (e) special health care needs, (f) expression and receptive language concerns, (g) psychosocial competence and problems and (h) temperament factors (approach, persistence and reactivity). Results indicated that special health care needs, receptive language concerns and all three temperament scales (approach, persistence and reactivity) significantly predicted conflict in teacher-child relationships. Close relationships were predicted by being female, indigenous status, higher socio-economic position, not having a special health care need and no expressive language concerns.

Temporal Characterization of Ossification of the Crania in Australian Subadults: New standards for Age Estimation using Computed Tomography

After attending this presentation, attendees will gain awareness of the ontogeny of cranial maturation, specifically: (1) the fusion timings of primary ossification centers in the basicranium; and (2) the temporal pattern of closure of the anterior fontanelle, to develop new population-specific age standards for medicolegal death investigation of Australian subadults. This presentation will impact the forensic science community by demonstrating the potential of a contemporary forensic subadult Computed Tomography (CT) database of cranial scans and population data, to recalibrate existing standards for age estimation and quantify growth and development of Australian children. This research welcomes a study design applicable to all countries faced with paucity in skeletal repositories. Accurate assessment of age-at-death of skeletal remains represents a key element in forensic anthropology methodology. In Australian casework, age standards derived from American reference samples are applied in light of scarcity in documented Australian skeletal collections. Currently practitioners rely on antiquated standards, such as the Scheuer and Black1 compilation for age estimation, despite implications of secular trends and population variation. Skeletal maturation standards are population specific and should not be extrapolated from one population to another, while secular changes in skeletal dimensions and accelerated maturation underscore the importance of establishing modern standards to estimate age in modern subadults. Despite CT imaging becoming the gold standard for skeletal analysis in Australia, practitioners caution the application of forensic age standards derived from macroscopic inspection to a CT medium, suggesting a need for revised methodologies. Multi-slice CT scans of subadult crania and cervical vertebrae 1 and 2 were acquired from 350 Australian individuals (males: n=193, females: n=157) aged birth to 12 years. The CT database, projected at 920 individuals upon completion (January 2014), comprises thin-slice DICOM data (resolution: 0.5/0.3mm) of patients scanned since 2010 at major Brisbane Childrens Hospitals. DICOM datasets were subject to manual segmentation, followed by the construction of multi-planar and volume rendering cranial models, for subsequent scoring. The union of primary ossification centers of the occipital bone were scored as open, partially closed or completely closed; while the fontanelles, and vertebrae were scored in accordance with two stages. Transition analysis was applied to elucidate age at transition between union states for each center, and robust age parameters established using Bayesian statistics. In comparison to reported literature, closure of the fontanelles and contiguous sutures in Australian infants occur earlier than reported, with the anterior fontanelle transitioning from open to closed at 16.7±1.1 months. The metopic suture is closed prior to 10 weeks post-partum and completely obliterated by 6 months of age, independent of sex. Utilizing reverse engineering capabilities, an alternate method for infant age estimation based on quantification of fontanelle area and non-linear regression with variance component modeling will be presented. Closure models indicate that the greatest rate of change in anterior fontanelle area occurs prior to 5 months of age. This study complements the work of Scheuer and Black1, providing more specific age intervals for union and temporal maturity of each primary ossification center of the occipital bone. For example, dominant fusion of the sutura intra-occipitalis posterior occurs before 9 months of age, followed by persistence of a hyaline cartilage tongue posterior to the foramen magnum until 2.5 years; with obliteration at 2.9±0.1 years. Recalibrated age parameters for the atlas and axis are presented, with the anterior arch of the atlas appearing at 2.9 months in females and 6.3 months in males; while dentoneural, dentocentral and neurocentral junctions of the axis transitioned from non-union to union at 2.1±0.1 years in females and 3.7±0.1 years in males. These results are an exemplar of significant sexual dimorphism in maturation (p<0.05), with girls exhibiting union earlier than boys, justifying the need for segregated sex standards for age estimation. Studies such as this are imperative for providing updated standards for Australian forensic and pediatric practice and provide an insight into skeletal development of this population. During this presentation, the utility of novel regression models for age estimation of infants will be discussed, with emphasis on three-dimensional modeling capabilities of complex structures such as fontanelles, for the development of new age estimation methods.

Costing the Australian National Hand Hygiene Initiative

Background The Australian National Hand Hygiene Initiative (NHHI) is a major patient safety programme co-ordinated by Hand Hygiene Australia (HHA) and funded by the Australian Commission for Safety and Quality in Health Care. The annual costs of running this programme need to be understood to know the cost-effectiveness of a decision to sustain it as part of health services. Aim To estimate the annual health services cost of running the NHHI; the set-up costs are excluded. Methods A health services perspective was adopted for the costing and collected data from the 50 largest public hospitals in Australia that implemented the initiative, covering all states and territories. The costs of HHA, the costs to the state-level infection-prevention groups, the costs incurred by each acute hospital, and the costs for additional alcohol-based hand rub are all included. Findings The programme cost AU$5.56 million each year (US$5.76, £3.63 million). Most of the cost is incurred at the hospital level (65%) and arose from the extra time taken for auditing hand hygiene compliance and doing education and training. On average, each infection control practitioner spent 5 h per week on the NHHI, and the running cost per annum to their hospital was approximately AU$120,000 in 2012 (US$124,000, £78,000). Conclusion Good estimates of the total costs of this programme are fundamental to understanding the cost-effectiveness of implementing the NHHI. This paper reports transparent costing methods, and the results include their uncertainty.

An Advanced Pharmacy Practice Framework for Australia

The need to develop An Advanced Pharmacy Practice Framework for Australia (the “APPF”) was identified during the 2010 review of the competency standards for Australian pharmacists. The Advanced Pharmacy Practice Framework Steering Committee, a collaborative profession-wide committee comprised of representatives of ten pharmacy organisations, examined and adapted existing advanced practice frameworks, all of which were found to have been based on the Competency Development and Evaluation Group (CoDEG) Advanced and Consultant Level Framework (the “CoDEG Framework”) from the United Kingdom. Its competency standards were also found to align well with the Domains of the National Competency Standards Framework for Pharmacists in Australia (the “National Framework”). Adaptation of the CoDEG Framework created an APPF that is complementary to the National Framework, sufficiently flexible to customise for recognising advanced practice in any area of professional practice and has been approved by the boards/councils of all participating organisations. The primary purpose of the APPF is to assist the development of the profession to meet the changing health care needs of the community. However, it is also a valuable tool for assuring members of the public of the competence of an advanced practice pharmacist and the quality and safety of the services they deliver.

Methodology for developing competency standards for dietitians in Australia

Competency standards document the knowledge, skills, and attitudes required for competent performance. This study develops competency standards for dietitians in order to substantiate an approach to competency standard development. Focus groups explored the current and emerging purpose, role, and function of the profession, which were used to draft competency standards. Consensus was then sought using two rounds of a Delphi survey. Seven focus groups were conducted with 28 participants (15 employers/practitioners, 5 academics, 8 new graduates). Eighty-two of 110 invited experts participated in round one and 67 experts completed round two. Four major functions of dietitians were identified: being a professional, influencing the health of individuals, groups, communities, and populations through evidence-based nutrition practice, and working collaboratively in teams. Overall there was a high level of consensus on the standards: 93% achieved agreement by participants in round one and all revised standards achieved consensus on round 2. The methodology provides a framework for other professions wishing to embark on competency standard review or development.

Genetic diversity of the Australian National Mango Genebank

Assessment of genetic diversity is an essential component in germplasm characterisation and utilisation. In this study the genetic diversity of mango was determined among 254 Mangifera indica L. accessions and related Mangifera species originating from 12 diverse geographic areas using eleven known simple sequence repeat (SSR) markers from mango. A total of 133 alleles were detected, ranging from eight (LMMA12) to 16 (MIAC-5) alleles per locus with a mean value of 12.36 and an average polymorphism information content (PLC) of 0.72. The mean number of alleles (8.45) was highest in the South East Asian accessions (Indonesia/Malesia) and lowest in the accessions from the Philippines (2.55). Diversity analysis divided the accessions into four major nodes broadly representing their geographical origins. The genetic diversity of 'Kensington Pride' was confirmed as being very low and no parents for this cultivar were identified. No association could be established between SSR markers analysed and embryony. Ten synonymous accessions were identified with matching genetic identity with at least one other accession at all SSR loci examined. Twenty-two unique genotypes were identified for 50 trees previously assigned different accession names. The remaining accessions were genetically distinct from each other. This increased understanding of genetic diversity in the Australian National Mango Genebank will assist breeders to better select parents with the potential to contribute desired genes to the progeny and thus more rapidly deliver improved cultivars to industry to meet consumer demand. Crown Copyright (C) 2012 Published by Elsevier B.V. All rights reserved.